Whenever your big toe hurts after running, it is worth investigating what may be going on. It could be an injury, shoe fit issue or an adjustment needed in your foot strength or flexibility program that needs addressing.
Pain in the big toe area is a common affliction among runners, often brought on by injuries such as sprains, arthritis, fractures or tendonitis of flexor hallucis longus tendonitis.
Hallux Rigidus
Hallux rigidus is a condition that causes pain and stiffness in your big toe, caused by wear-and-tear wear in its joint cartilage. Over time, bone spurs form and your big toe becomes stiff. Eventually it may not bend.
Your healthcare provider will diagnose hallux rigidus by performing a physical exam. They may take X-rays of the affected joint(s), examine for bone spurs, and inquire into symptoms as well as activity levels. They’ll also ask about symptoms related to activities and lifestyle.
Non-surgical approaches for hallux rigidus typically include avoiding activities that put too much stress on the big toe joint, taking over-the-counter pain relievers such as NSAIDs to manage inflammation and control pain, or injection of dexamethasone phosphate may provide some patients with relief. Surgery may also help alleviate hallux rigidus; in these instances it involves surgically extracting any arthritic tissue or bone spurs in your big toe joint using arthrodesis – this procedure will improve movement within it and could potentially improve movement for your big toe joint.
Sesamoiditis
Sesamoiditis is an inflammatory condition that causes pain under the big toe on the ball of the foot, typically seen among runners due to repeated stress and impact on their feet. Two small jelly bean-like bones called sesamoids (hence their name) embedded within a tendon called FHL tendon at the base of big toe are responsible for providing power and leverage when pushing off, making flexor hallucis longus tendon more vulnerable when wearing shoes with poor support or high arch arches and thus making them vulnerable against potential injury.
Sesamoiditis symptoms typically include dull, chronic pain under the big toe that comes and goes over time when wearing certain shoes or engaging in weight bearing activities, especially when wearing certain styles of footwear or engaging in specific weight bearing activities. Unfortunately, sesamoid injuries can be hard to identify, leading to permanent damage over time if left untreated quickly; sudden pain could indicate fractured sesamoids.
Bunions
Bunions are painful bony bumps that form at the big toe joint – also known as the first metatarsophalangeal (MTP) joint – over time, slowly altering your alignment and force applied when pushing off during running and leading to altered force distribution, altering how far inwards your big toe points toward smaller toes, altering alignment force when applying pressure when pushing off, leading to altered alignment force force application, leading to altered force distribution when pushing off as well as potential chafing or pain from shoes.
Bunions’ causes remain uncertain; it could be hereditary and more prevalent among women than men. Other risk factors could include wearing tight shoes, being overweight, and suffering an injury which puts pressure on the big toe joint. Rheumatoid arthritis and diabetes increase your risk for bunions as well.
Wearing wide shoes that provide ample room in the toe box can help to prevent bunions. In addition, using bunion pads, gels or wraps may also help alleviate irritation on protruding big toes.
Turf Toe
Turf toe is an injury often seen among football players and other athletes who play on artificial surfaces where their feet stick, leading to jamming of the big toe. Pain results from stretching or tearing of ligaments in the metatarsophalangeal (MTP) joint; which comprises ligaments, tendons and two sesamoids named for their similarity to sesame seeds forming this complex structure.
Your doctor can diagnose turf toe through taking your medical history, conducting a physical exam and using imaging tests such as X-rays or an MRI to examine structures around your big toe joint. An X-ray may show any bone damage while an MRI provides more details of MTP joint area. In addition, your doctor will ask you to bend and move your toe to assess its range of motion; any limitation in motion suggests turf toe as a possible diagnosis.
